An assessment of the variation in the practice of lumbar discectomy and its role in axial back pain

Background: Lumbar discectomy is performed for symptomatic lumbar disc herniation and is one of the most widely performed spinal surgical procedures worldwide in a variety of ways. This survey aimed at providing an overview/perspective of different practice patterns and the impact of lumbar discecto...

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Bibliographic Details
Main Authors: Sandeep Mishra, Kanwaljeet Garg, Bipin Chaurasia, Bhargavi R Budihal, Harsh Deora, Vivek Tandon, Manoj Phalak, Shashwat Mishra, Amandeep Kumar, G E Umana, Jesus Lafuente, Andreas K Demetriades, Yoon Ha, Manmohan Singh, P S Chandra, S S Kale, Mehmet Zileli
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2023-01-01
Series:Journal of Craniovertebral Junction and Spine
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Online Access:http://www.jcvjs.com/article.asp?issn=0974-8237;year=2023;volume=14;issue=3;spage=259;epage=267;aulast=Mishra
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Summary:Background: Lumbar discectomy is performed for symptomatic lumbar disc herniation and is one of the most widely performed spinal surgical procedures worldwide in a variety of ways. This survey aimed at providing an overview/perspective of different practice patterns and the impact of lumbar discectomy on axial back pain with or without sciatica. Methods: An online survey was performed using the application “Google Forms.” The link to the questionnaire was distributed to neurosurgeons through personal E-mail and social media platforms. Results: We received 333 responses. The largest percentage of responses across five continents was from Asia (66.97%, n = 223). The mean age of the respondents was 40.08 ± 10.5 years. A total of 66 respondents (20%) had a spine practice of 7%–90%, and 28 respondents had a spine practice of 90%–100% (8.4%). The number of respondents who practiced microscopic discectomy using a tubular retractor (n = 143 respondents, 42.9%) was nearly equal to the number of respondents who practiced open discectomy (n = 142 respondents, 42.6%). An almost equal proportion of respondents believed discectomy does not help in relieving axial back pain. Only 20.4% (n = 68) of respondents recommend bed rest for a longer duration postoperatively. Conclusions: Our survey revealed that only 22.2% of spine surgeons recommended discectomy in patients with radiological disc herniation with axial back pain alone and preferred a minimally invasive method of discectomy. Almost half of them believed discectomy to be ineffective for axial low back pain and only a few recommended prolonged bed rest postoperatively.
ISSN:0974-8237